What does the public know about Ebola? The public’s risk perceptions regarding the current Ebola outbreak in an as‐yet unaffected country
To access this article in the American Journal of Infection Control, please go to http://www.ajicjournal.org/article/S0196‐6553(15)00150‐9/abstract Anat Gesser‐Edelsburg1*†, Yaffa Shir‐Raz1, Samah Hayek1 and Oshrat Sassoni‐Bar Lev2
Anat Gesser‐Edelsburg, PhD1, Ave. Mount Carmel, Haifa 3498838, Israel
Ronit Endevelt, RD, MSc, PhD1, Yaara Tirosh‐Kamienchick, RD, BSc1
1. School of Public Health, University of Haifa, 199 Aba Khoushy
2. Department of Communication, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa 3498838, Israel
1 School of Public Health, Haifa University, Haifa, Israel
* Corresponding Author [email protected]
† Head of Health Promotion Program, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa 3498838, Israel
Targeting Ebola International Congress 2015: Scientific Bases & Applications, Pasteur Institute, Paris, May 28‐29, 2015
Results
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Highlights
•The public has knowledge about Ebola and is updated on the topic, including scientific issues that are on the agenda, such as the question of Ebola transmission.
•No statistically significant difference was found between health care workers versus nonhealth care workers in the knowledge and worry score.
•The public expects information about Ebola from health authorities, including topics of uncertainty.
•More than half of the participants thought the information provided by health authorities on Ebola and Ebola prevention was insufficient, and almost half were unsure if the information was sufficient.
Background
The unexpected developments surrounding the Ebola virus in the United States provide yet another warning that we need to establish communication preparedness. This study examines what the Israeli public knew about Ebola after the initial stages of the outbreak in a country to which Ebola has not spread and assesses the association between knowledge versus worries and concerns about contracting Ebola.
Methods
Online survey using Google Docs (Google, Mountain View, CA) of Israeli health care professionals and the general public (N = 327).
Table 1
Distribution of knowledge, worry, and expectation from the Ministry of Health in Israel (N = 327)
Measure/Question
Knowledge
Definition of Ebola
An infection transmitted from person to person
It is not a contagious infection
Do not know
Missing
Transmission route
Fluid (eg, blood, saliva, feces, etc)
Air droplets
Do not know because scientists are uncertain
Do not know
Missing
Who can contract Ebola
Immigrants or international workers from Africa
Everyone
Pregnant women and children
Health care workers (doctors, nurses, etc)
Missing
Treatment for Ebola or vaccine
There is a specific treatment for Ebola
As of today, there is neither a vaccine nor any specific treatment for Ebola
As of today, there is no specific treatment for Ebola, but there is a vaccine
Do not know
Missing
Severity of Ebola
Fatal disease
It is a dangerous disease that can be fatal, only for people at risk
Ebola is dangerous, but it is possible to recover
Ebola is not dangerous at all
Do not know
Missing
Knowledge score
Knowledge score for correct answers
Value
306 (94.4)
2 (0.6)
16 (4.9)
3
170 (52.6)
82 (25.4)
33 (10.2)
38 (11.8)
4
26 (8.1)
294 (91.3)
1 (0.3)
1 (0.3)
5
34 (10.6)
224 (70.0)
29 (9.1)
33 (10.3)
7
244 (76.3)
37 (11.6)
25 (7.8)
0 (0.0)
14 (4.4)
7
4.18 ± 0.83 (2‐
5)
(continued)
Measure/Question
Worry
Risk of an Ebola outbreak in Israel
High (>50%)
Medium (50%)
Low (<50%)
Missing
Worry about contracting Ebola
High
Medium
Low
Missing
Expectation from the Ministry of Health
Receiving more information from the Ministry of Health
Yes, just in case we have reported cases in Israel Yes, now
Not interested to get any kind of information
Missing
If you answered yes to the previous question, what kind of information would you like?
What to do to prevent the transmission
Everything related to Ebola, treatment, and prevention (also subjects that include scientific uncertainty)
Everything related to Ebola, but just for topics that have scientific certainty
Missing
Extent of agreement that the Ministry of Health provided comprehensive information on Ebola
Strongly agree
Agree
Not sure
Disagree
Strongly disagree
Missing
Extent of agreement that the Ministry of Health provided comprehensive information on Ebola prevention Strongly agree
Agree
Not sure
Disagree
Strongly disagree
Missing
NOTE. Values are n (%), n, or mean ± SD.
Value
24 (7.7)
98 (30.3)
201 (62.2)
4
73 (22.6) 108 (33.4)
142 (43.9)
4
The Israeli public has knowledge about Ebola (mean ± SD, 4.18 ±
0.83), despite the fact that the disease has not spread to Israel (Table 1). No statistically significant difference was found between health care workers versus nonhealth care workers in the knowledge score (Table 2). Additionally, no statistically significant association was found between knowledge and worry levels (Table 3). Table 2
Differences between health care workers versus nonhealth care workers in the overall knowledge level, of who could contract Ebola, and Ebola treatment or vaccine
Measure/Question
Health care workers
Overall knowledge level (score), mean ± SD
4.15 ± 0.82
Infected with Ebola
Immigrants or international workers from Africa
1 (1.4)
Everyone
68 (97.1)
Pregnant women and children
0 (0.0)
Health care workers (doctors, nurses, etc)
1 (1.4)
Treatment for Ebola or vaccine
There is a treatment for Ebola
3 (4.3)
6 (8.7)
As of today, there is no treatment for Ebola, but there is a vaccine for Ebola
57 (82.6)
As of today, there is neither a treatment for Ebola nor a vaccine
Do not know
3 (4.3)
NOTE. Values are n (%), n, or as otherwise indicated.
*P value is statistically significant at P < .05.
†For categorical variables the χ2 test is used, and for continuous variables the t test is used.
43 (14.7)
157 (54.0)
91 (31.3)
36
8 (2.5)
25 (7.8)
145 (45.2)
99 (30.8)
44 (13.7)
6
3 (0.9)
24 (7.5)
132 (41.1)
117 (36.4)
45 (14.0)
6
χ2 test or t test*
‐1.13
9.19
P value
0.259
0.027†
8.63
0.035†
25 (10.1)
221 (89.5)
1 (0.4)
0 (0.0)
31 (12.6)
22 (8.9)
163 (66.3)
30 (12.2)
Table 3
Ordinal logistic regression for the association between knowledge level and worry level for Israelis to contract Ebola and for Ebola to break out in Israel
Worried to be infected
Worried to find Ebola cases in Israel
Demographic characteristics
High
Medium
Low
High
Medium
Age
0.98 (0.94‐1.02)
0.97 (0.95‐0.99)*
Ref
1.00 (0.97‐1.02)
0.99 (0.97‐1.01)
P value
0.273
0.009
0.923
0.524
Sex
Male
Ref
Ref
Ref
Ref
Ref
1.38 (0.72‐2.65)
Female
2.39 (0.75‐3.59)
2.19 (1.30‐4.27)*
0.94 (0.46‐1.96)
P value
0.139
0.020
0.883
0.331
Education
≤High school
Ref
Ref
Ref
Ref
Ref
≥High school
NS
1.04 (0.29‐3.78)
0.88 (0.19‐4.11)
0.80 (0.19‐3.36)
P value
0.538
0.220
0.693
Academic degree
NS
Ref
0.13 (0.11‐1.63)
0.46 (0.14‐1.57)
0.59 (0.20‐1.75)
P value
0.157
0.085
0.110
Health care worker
Ref
Ref
Ref
Health care worker
Ref
Ref
Nonhealth care worker
1.99 (0.51‐7.85)
1.56 (0.75‐3.27)
1.75 (0.70‐4.43)
1.84 (0.72‐3.07)
P value
0.324
0.235
0.228
0.290
Knowledge score
1.05 (0.56‐1.97)
1.18 (0.82‐1.72)
Ref
0.88 (0.58‐1.34)
1.04 (0.71‐1.51)
P value
0.875
0.377
0.555
0.848
NOTE. Values are odds ratio (95% confidence interval) or as otherwise indicated.
NS, odds ratio included a wide interval that yielded an insignificant outcome because of the small numbers in the high level category of the worry level; Ref, reference.
*P value is statistically significant at P < .05.
Low
Ref
Ref
Ref
Ref
Ref
Ref
The survey indicated that Israelis expect information about Ebola from the health ministry, including topics of uncertainty. More than half of the participants thought the information provided by the health ministry on Ebola and Ebola prevention was insufficient (50.5% and 56.4%, respectively), and almost half (45.2% and 41.1%, respectively) were unsure if the information was sufficient.
Conclusion
The greatest challenges that the organizations face is not only to convey knowledge, but also to find ways to convey comprehensive information that reflects uncertainty and empowers the public to make fact‐based decisions about health.
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